Andy Kinnear explains why digitisation of the health and social care system is absolutely critical to the future of the NHS and why he’s passionate about establishing professional standards for informatics.
Please introduce yourself and your work
I’ve got four roles in life: Director of Digital Transformation for NHS South, Central and West CSU. I’m also the programme director for a piece of work called Connecting Care. It looks at boundaries between organisations. That programme’s success led me to do some consulting work for NHS Digital. I’m also the Chair of the BCS Health and Care Executive. I’ve a real passion about professionalising the way in which we deliver digital services in the health and care sector.
How do you define a successful digital health and social care system?
It’s affordable, it’s efficient and it supports our patients and our public. And, I think, it’s a happy place to work.
Digging deeper, I think it’s a seamlessly integrated health and care system - it’s a place where it’s impossible to see the boundaries between the services. It’s somewhere where the idea of service relates to the full experience, not just to a particular point-of-care moment. For me, again, it’s a system where the patient feels like they are truly in control and genuinely at the centre of the system. And, it’s a place where the staff are proud to be part of the whole organisation.
How important is moving the NHS toward a paperless future?
It’s like asking: ‘How important is tarmacking the roads to the transport industry?’ It’s critical. Absolutely critical. The ability to share information about the people we serve across the health and social care system is absolutely fundamental to providing people with the service they deserve. It is, to put it another way, nigh on impossible to deliver a high quality service when information is stored on paper.
What structures, programmes and organisations exist to define and manage this change?
There are four engines that are driving the delivery of digital health and care. First there is The Department of Health and NHS England - these guys define our policy, set out strategy and provide us with the funding delivery.
The second engine is NHS Digital - the national agency charged with delivering health and care’s digital future. They’re delivering a set of products that are used nationally. They’re also defining a set of standards that govern how things deployed at a local level operate.
The third engine is more disparate: It’s all the people who work in digital health at a local level. And finally, the fourth engine is our solution suppliers and vendors.
If they all make the engine, the vehicle being driven forward is the Paperless 2020 strategy. Paperless 2020 is the National Information Board’s strategy.
At the moment it’s a very positive environment. We’ve got a national digital health strategy that makes sense all the way from Whitehall to the hospital ward.
Is Paperless 2020 a technical, a behavioural or a cultural challenge?
This goes to the heart of why this programme is so complicated. Delivering the technical solution just gets you to the start line. The behavioural and cultural challenges are far greater. Behaviourally we’ll see an erosion of the traditional organisational boundaries that exist between primary and secondary care, or between community services and social care. People will feel less bound by those constructs.
Culturally we’ll need to see a change in the way that digital solutions are adopted. At the moment you can still be a successful clinician in the health service without adopting digital good practice.
It’s still possible to operate on paper. If that carries on it’ll undermine patient safety and it’ll stop information being shared across boundaries. So, over the next five to ten years we’ll see huge cultural shifts as digital becomes more embedded.
Effective data privacy is a cornerstone of effective data sharing. How are you going to get patients onboard?
The patient engagement piece is critically important, but needn’t hold any fear for us. In a way we’re pushing on an open door. Patients certainly need to be engaged in a dialogue around why it is helpful for the care system to share their personal data.
But in my experience - and I’ve a lot of experience of working on shared record programmes - most members of the public believe this stuff is already happening. People have an open expectation that the NHS will share their information - when that sharing is done safely, securely and done to support care outcomes.
To complement that, we have some very comprehensive recommendations under the Dame Fiona Coldicott report version three. They require us to ensure that we have consent from patients to use their data and the way that we share it.
How do you foresee clinician training changing in the future?
The clinical workforce that is coming through in the next generation will be a cohort of people who have lived their entire lives in a digital world. These people are digitally enlightened, digitally capable and they are digitally expectant - they’ll live and work digitally.
So, we will need to train our clinicians to use digital solutions within their professional sphere, but I don’t think that will be the challenge people fear it will be. The generation we’re looking at will frankly expect to work digitally.
Why did you take the BCS Health and Care chair?
Because I’m passionate about driving up the level of professional delivery inside the health and care system. Currently we’ve loads of talented people working their socks off, but we don’t have that structured career plan that helps them develop a future.
We don’t always have continuing professional development requirements that require people to invest time in their own development.
We don’t have professional registration of informatics workers. As a result we don’t always get the respect we deserve from other professionals within the health and care system - people who do, perhaps, have professional registration. So, I’m keen to be part of an organisation that can bring that digital future into being.
Ultimately, the digital future is critical. And that future needs to be in the hands of people that are professionally capable, qualified and supported to deliver.
There is a Clinical Bioinformatics (Health Informatics) Professional Registration with the HCPC.
I think there needs to be more talks between the BCS and the Academy of Healthcare Sciences.
I definitely welcome professional registration.
To add to Andrew's observations, there is (to name but a few examples) considerable other related experience since 2002 (UKCHIP), the NHS HI Career Framework (www.hicf.org.uk) and a number of academic programmes from Foundation degree to Masters that can feed into positive professional developments that may come from the emerging Federation for Informatics Professionals working in Health and Social Care to widen recognition and registration.
Are there any links to NHSS? or is this only for England?
Great start to your valuable leadership in the critical H&SC sector.
Keep up the good work!